How much rates vary
Facilitymedian $6,607 · 10th to 90th $2,692 to $12,589Professionalmedian $355 · 10th to 90th $52 to $1,862
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $1,230.27 Median $3,311.31 Typical High $9,120.11 | Facility | None | $1,230.27 | $3,311.31 | $9,120.11 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $1,995.26 | Professional | None | $1,380.38 | $1,548.82 | $1,995.26 |
Ambetter Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
BCBS Texas Setting Facility Modifier None Typical Low $3,715.35 Median $7,079.46 Typical High $15,848.93 | Facility | None | $3,715.35 | $7,079.46 | $15,848.93 |
BCBS Texas Setting Professional Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $2,691.53 | Professional | None | $1,513.56 | $1,905.46 | $2,691.53 |
Christus Setting Facility Modifier None Typical Low $8,128.31 Median $8,128.31 Typical High $8,128.31 | Facility | None | $8,128.31 | $8,128.31 | $8,128.31 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $4,265.80 Typical High $6,025.60 | Facility | None | $758.58 | $4,265.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,513.56 | $1,862.09 | $2,570.40 |
Lucent Health Setting Professional Modifier None Typical Low $11,748.98 Median $11,748.98 Typical High $12,882.50 | Professional | None | $11,748.98 | $11,748.98 | $12,882.50 |
Moda Health Setting Facility Modifier None Typical Low $977.24 Median $3,090.30 Typical High $12,302.69 | Facility | None | $977.24 | $3,090.30 | $12,302.69 |
Moda Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $2,187.76 | Professional | None | $1,380.38 | $1,548.82 | $2,187.76 |
Molina Setting Professional Modifier None Typical Low $47.86 Median $263.03 Typical High $1,348.96 | Professional | None | $47.86 | $263.03 | $1,348.96 |
Providence Setting Facility Modifier None Typical Low $794.33 Median $4,168.69 Typical High $6,025.60 | Facility | None | $794.33 | $4,168.69 | $6,025.60 |
Providence Setting Professional Modifier None Typical Low $1,513.56 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,513.56 | $1,862.09 | $2,570.40 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $6,456.54 Typical High $15,135.61 | Facility | None | $2,630.27 | $6,456.54 | $15,135.61 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $2,570.40 | Professional | None | $1,288.25 | $1,659.59 | $2,570.40 |
Wellpoint Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
12 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $676.08 Median $758.58 Typical High $870.96 | Professional | 52 · Reduced service | $676.08 | $758.58 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $302.00 Typical High $346.74 | Professional | 53 · Discontinued | $275.42 | $302.00 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,122.02 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,023.29 | $1,122.02 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $229.09 Typical High $263.03 | Professional | 55 · Aftercare only | $204.17 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $151.36 Typical High $173.78 | Professional | 56 · Pre-op care only | $138.04 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,047.13 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $954.99 | $1,047.13 | $1,230.27 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $676.08 Median $758.58 Typical High $851.14 | Professional | 52 · Reduced service | $676.08 | $758.58 | $851.14 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $302.00 Typical High $338.84 | Professional | 53 · Discontinued | $275.42 | $302.00 | $338.84 |
Moda Health Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,122.02 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,023.29 | $1,122.02 | $1,288.25 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $229.09 Typical High $257.04 | Professional | 55 · Aftercare only | $204.17 | $229.09 | $257.04 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $151.36 Typical High $169.82 | Professional | 56 · Pre-op care only | $138.04 | $151.36 | $169.82 |
Moda Health Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,047.13 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $954.99 | $1,047.13 | $1,202.26 |
Where Texas sits
The same service costs 7.8 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Texas· 51st of 51
$871
AK $6,761TX $871
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.